This question presents the ultimate heart wrenching and soul searching issue you may have to address
A great way to start this debate is to read the thoughtful articles in ADDitude magazine on this topic. They also discuss alternative therapies and treatments - http://www.additudemag.com/topic/adhd-treatment/adhd-medication.html
Next: go to this link and read the interview with Dr. Barkley - then see and share the PBS Frontline video on this topic (keep a tissue handy) http://www.pbs.org/wgbh/pages/frontline/shows/medicating/interviews/barkley.html#
[click where it says - "Watch online"]
Also, you should become familiar with the 'Multi modal'/ 'MTA' Study AND the Follow Up. Basically, the National Institute of Mental Health conducted a longitudinal study (meaning, it was conducted over an extended period of time) to determine what treatments or combintations of treatments was most effective. Later a follow up was conducted. http://www.pbs.org/wgbh/pages/frontline/shows/medicating/interviews/barkley.html#
(be sure to recognize the limitations of these studies)
Here are thoughtful articles to consider when weighing your options -
Also- read "A Child in the Balance..." by Kevin Kalikow
(see my book list and this link) -
Once again, consider the studies that have been done by Consumer Reports on treatments
AND - the Consumer Reports review of ADHD medication -
How Does Medication Work For ADHD? Click on the Pill to see an informative video on the science of ADHD Rx
ADHD and Substance Abuse
Attention-deficit/hyperactivity disorder (ADHD) and substance use disorders are inextricably intertwined. Children with ADHD are more likely than peers to develop substance use disorders. Treatment with stimulants may reduce the risk of substance use disorders, but stimulants are a class of medication with significant abuse and diversion potential. The objectives of this clinical report were to present practical strategies for reducing the risk of substance use disorders in patients with ADHD and suggestions for safe stimulant prescribing.
Here are my thoughts on this topic - at all times you have to consider what you think is best for your child and which course of action you feel will best equip them to excel. I believe it is a parent's duty to provide them with every opportunity to succeed and that their personal thoughts, fears or prejudices should take a back seat.